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Individual

MISS JESSI LYN RIVERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
1715 N WEST SHORE BLVD STE 410, TAMPA, FL 33607-3902
(855) 623-3587
Mailing address
1619 E PEACHAM RD, PEACHAM, VT 05862-7900
(802) 752-5392

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
026.0095693
VT
163W00000X
Registered Nurse
082322-21
NH
163W00000X
Registered Nurse
176787
CT
163W00000X
Registered Nurse
808927
NY
163W00000X
Registered Nurse
RN-TEMP3816
MA

Other

Enumeration date
01/26/2021
Last updated
01/27/2021
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